mpMRI成像在前列腺疾病诊断中的临床应用研究

Clinical application of mpMRI imaging in the diagnosis of prostate diseases

目的探讨多参数MRI成像对前列腺外周带及移行带病变的诊断价值。方法分析我院前列腺疾病患者63例行多参数MRI资料,依据PI-RADS V2对外周带病变及移行带病灶进行影像学评分,使用small FOV T 2WI及超高b值DWI;临床病理资料完整并获得前列腺癌患者Gleason评分。外周带病变及移行带病变PI-RADS V2评分分别与其Gleason评分进行相关性分析并获得r值;计算PI-RADS V2评分的灵敏度、特异度、阳性预测值及阴性预测值。结果63例患者共发现96个病灶,其中外周带病灶52个,移行带病灶44个;外周带癌灶PI-RADS V2评分与病理Gleason评分呈正相关,r值=0.673;移行带癌灶PI-RADS V2评分与病理Gleason评分呈正相关,r值=0.482;周围带病灶PI-RADS V2评分灵敏度为97.7%,特异度为75%,阳性预测值为95.6%,阴性预测值为85.7%;移行带病灶PI-RADS V2评分灵敏度为78.6%,特异度为93.3%,阳性预测值为84.6%,阴性预测值为90.3%。结论前列腺多参数MRI扫描可以较好的显示前列腺外周带及移行带病变,病变PI-RADS V2评分与病理结果具有较好的相关性,多参数MRI对前列腺不同区域病变的诊断具有临床意义。

Objective To evaluate the diagnostic value of multi parameter MRI in the diagnosis of lesions around the prostate and transitional zone.Methods From June 2016 to Navember 2018,63 patients who underwent mpMRI in our hospital were analyzed.According to PI-RADS V2,the peripheral lesions and transitional lesions were scored.On the basis of routine scanning,high resolution small field of vision and high b value DWI were added.The clinical pathological data were completed and Gleason score of prostate cancer patients was obtained.The PI-RADS V2 scores of peripheral lesions and transitional lesions were correlated with their Gleason scores and rvalues were obtained.The sensitivity,specificity,positive predictive value and negative predictive value of PI-RADS V2 scores were calculated.Results A total of 96 lesions were found in 63 patients,including 52 peripheral lesions and 44 transitional lesions;PI-RADS V2 score of peripheral lesions was positively correlated with pathological Gleason score,r-values=0.673;PI-RADS V2 score of transitional lesions was positively correlated with pathological Gleason score,r value=0.482;sensitivity of PI-RADS V2 score of peripheral lesions was 97.7%,specificity was 75%,positive predictive value was 95.6%,negative predictive value was 85.7%;PI-RADS V2 score sensitivity was 78.6%,specificity was 93.3%,positive predictive value was 84.6%,and negative predictive value was 90.3%.Conclusion Prostate multi parameter MRI scan can better display the periprostatic and transitional zone lesions.PI-RADS V2 score of the lesions has a good correlation with the pathological results.Multi parameter MRI is of great significance in the detection and diagnosis of prostate lesions in different regions.